Comorbid Disease in Persons With Traumatic Brain Injury: Descriptive Findings Using the Modified Cumulative Illness Rating Scale

Holcomb EM, Millis SR, Hanks RA. Comorbid disease in persons with traumatic brain injury: descriptive findings using the Modified Cumulative Illness Rating Scale. Arch Phys Med Rehabil 2012;93:1338-42. Objective: To provide descriptive findings regarding the overall health status and prevalence of medical comorbidities experienced by traumatic brain injury (TBI) patients. Design: Inception cohort design with cross-sectional follow-up at 1 to 15 years. Setting: Rehabilitation hospital. Participants: Adults (N = 258) with moderate to severe TBI. Interventions: Not applicable. Main Outcome Measure: The Modified Cumulative Illness Rating Scale is a 14-item rating scale used to indicate health status by rating impairment across 14 different domains. Results: The TBI sample had lower rates of comorbidities compared with other rehabilitation populations, including stroke and orthopedic samples. The most commonly encountered medical conditions within our sample were eyes, ears, nose, and throat problems, psychiatric or behavioral disturbances, hypertension, and musculoskeletal injury at mild to moderate severity. Prevalence of conditions did not differ by sex, race, or cause of TBI. Conclusions: The current TBI sample was relatively healthy with few medical comorbidities. Further, the Modified Cumulative Illness Rating Scale may better be used as a standardized checklist to assess for the presence of co-occurring conditions, given the near absence of conditions in the higher range of severity.